Provider Demographics
NPI:1831967876
Name:ABUSUBAIH, LANA (MD)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:ABUSUBAIH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 PROVIDENCE PL APT 263
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-7008
Mailing Address - Country:US
Mailing Address - Phone:401-996-9981
Mailing Address - Fax:
Practice Address - Street 1:903 PROVIDENCE PL APT 263
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-7008
Practice Address - Country:US
Practice Address - Phone:401-996-9981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP06094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine